Tracking SIM practice transformation efforts 
January 31, 2018
SIM completes practice application process

The Colorado State Innovation Model (SIM) closed its final practice application this month for the third cohort that will start its work this summer. More details on the last SIM cohort will be shared in the coming weeks though it's important to note that several groups that participated in cohort-1 submitted new practice applications for cohorts 2 and 3, which illustrates the value of this federally funded, governor's office initiative.
 
While SIM cohort-1 participation officially ends March 31, we hope practices will remain involved in the initiative and are pleased to offer an extension of the following benefits: Stratus™ licenses through 2018, access to the SIM electronic clinical quality measure extraction solution (outlined below), attendance at upcoming SIM Collaborative Learning Sessions and Multi-Stakeholder Symposiums and access to SIM-funded education. Cohort-2 practices received their SIM Practice Feedback Reports in January that summarize baseline results and compare practices with others in the cohort. 
Measuring success, proving value: A SIM journey

Practice transformation requires staff time, resources and a commitment to redesigning processes to ensure the delivery of patient-centered, team-based, integrated healthcare. The Colorado State Innovation Model (SIM) team appreciates the work you do and continues to seek ways to highlight SIM practices with state executives, health plans and patients. As we approach the two-year mark for cohort-1 practices that end their formal participation in SIM March 31, the team continues to gather and share stories of success.

"It's been very valuable," Cindy Mattingly, RN, BSN, manager of practice transformation for Rocky Mountain Health Plans, said about SIM practice implementation during the Jan. 18 Multi-Stakeholder Symposium (MSS). "It's really exciting to see how all of this has grown and the value that you get by participating," she added.

Mattingly joined representatives from SIM cohorts 1 and 2 practices, health plans that support SIM and practice transformation organizations (PTOs) at the MSS, which is designed to foster respectful discussion about practice transformation work and alternative payment models (APMs) that support it. This was the first MSS for cohort-2 practices and highlighted the need for more frequent discussions between practices and payers about how practices are evaluated, what payment support looks like and ways to develop closer partnerships.

Surveys for MSS events from January 2017 through January 2018 show that 76% of attendees picked good or excellent to describe their experience. 

"Being able to put names to faces in a setting like the SIM Multi-Stakeholder Symposiums really deepens the commitment to seize this opportunity to work together toward the quadruple aim," said Beth King, quality coordinator, Associates in Family Medicine, a Fort Collins-based cohort-1 and cohort-2 practice representative.

Challenges to adopting digital health

Recent studies suggest that digital health technologies offer many benefits to patients and healthcare providers, but there are challenges that prevent or delay adoption. Prime Health, a non-profit organization that promotes alignment between healthcare technology entrepreneurs and industry stakeholders, is interviewing Colorado healthcare representatives to understand barriers and align priorities between these two communities. SIM practices are encouraged to complete this short survey to help bridge the gap between theory and practical implementation of digital health technology.
Child Health Plan Plus funding renewed

Congress renewed federal funding for the  Child Health Plan Plus (CHP+) program (CHIP) for six years and the bill was signed into law. Read statements from Governor John Hickenlooper and the Department of Health Care Policy and Financing (HCPF). HCPF has started notifying CHP+ members that the program will continue and will publish updates on the CO.gov/HCPF/FutureCHP web page as well as its Future of CHP+ newsletter.
Deadline looms for cohort-2 small grants

Apply for up to $40,000 by Feb. 6 and use funds provided by the Colorado Health Foundation to meet SIM milestones and achieve practice goals. Review information on the website , read the application instructions  and contact Meg Quiat, SIM small grants administrator, (meg.quiat@state.co.us) with questions.
Patient recognizes a difference in care

Work to transform practice operations to be more patient-centered and integrated are acknowledged by a patient in this episode of Innovation Insights, in which care team members from Roaring Fork Family Practice, a SIM cohort-1 practice in Carbondale, Colo., hear a patient's perspective. Stay tuned for more updates and follow us on SoundCloud to get a notification when new episodes are added.
SIM practices benefit from automated eCQM extraction

In March SIM will launch a service to help primary care practices extract electronic clinical quality measures (eCQMs) from electronic health records (EHRs). The SIM investment creates a technical and operational infrastructure so that eCQMs can be extracted from EHRs once and reported to different approved entities, a task that is frequently cited as a barrier to success with alternative payment models (APMs). The investment builds on existing state efforts and will help reduce administrative burden. To ensure success, the SIM team is creating a data governance committee to develop a foundational governance structure for eCQM data use. Apply by March 3.
Help evaluate SIM

SIM practices will be asked to participate in an evaluation of the state's ability to accelerate healthcare transformation in ways that result in better quality care, smarter spending, and healthier people. Watch for an email from a group of independent, federal evaluators for SIM round 2 states (including Colorado) to learn about new models of healthcare delivery.  Starting in February, SIM practices will receive emails from the federal evaluation team, which includes RTI International, The National Academy for State Health Policy, and The Henne Group (federal evaluation team), to gauge interest and willingness to participate in focus groups or interviews. Emails from the team will end in @thehennegroup.com, @rti.org, or @nashp.org. 

This team will be in the Denver area Feb. 28, March 1 and March 2 to conduct focus group discussions and key informant interviews with SIM physicians, nurse practitioners and behavioral health providers. Focus group discussions will last 60 minutes and participants will receive a $300 stipend for their time. Key informant interviews will last 60 minutes, will take place in person (at your office, a location of your choosing or over the phone) and no stipend will be provided.
SIM releases data reports

Read the latest installment of SIM rapid-cycle feedback reports that are created by TriWest, an independent evaluator, regarding program implementation. Each report focuses on a component of SIM. This report features comparisons of baseline and updated practice assessments from April through June 2017. Topics include data quality, provider satisfaction, behavioral health integrations and quality measure reporting. In addition to the quarterly rapid cycle feedback reports, TriWest produced an annual report that covers the first grant year of SIM's implementation (Feb. 1, 2016 through June 30, 2017).
What questions do you have about behavioral health data sharing?

SIM is creating a scenario-based 42 CFR Part 2 FAQ document to help providers share behavioral health data by illustrating scenarios that are covered under 42 CFR Part 2. Please help us customize this resource to ensure that the questions/scenarios are useful for your care team. Send us your top five questions about data sharing under 42 CFR Part 2.
Apply for the SBIRT program

SIM practices are encouraged to investigate the Substance Abuse and Mental Health Services Administration (SAMHSA) application for the Screening, Brief Intervention, and Referral to Treatment (SBIRT) program totaling up to $39.8 million during the next five years. The goal is to implement SBIRT for adolescents and adults in primary care and community health settings for substance misuse and substance use disorders. SAMHSA expects to fund as many as eight grantees with up to $995,000 per year for up to five years. Applications are due by Feb. 21 at 11:59 p.m. Learn more.
QI resource for practices

The American Medical Association will host a one-hour webinar titled "Developing a quality improvement culture in a practice setting" from 1-2 p.m. EST Feb. 21 to help practices develop a QI culture. Click here to register.
Health and wellness expo video

Regional health connectors (RHCs), a state workforce that is partially funded by SIM, are connecting practice teams with valuable resources to help patients live healthier lives and to advance local health goals. Get an example of this work in this  health and wellness expo video  which was created by the Mile High Alliance and features Stephanie Salazar-Rodriquez, an RHC. And get more information about RHCs on the website.
Redefining mental health: An event in Denver

Register for a community conversation about redefining mental health on Feb. 22 with Patrick J. Kennedy and local leaders in mental health. The event, which is hosted by the University of Denver's Graduate School of Professional Psychology and its Center for Oncology Psychology Excellence, will focus on changing the way we treat and talk about mental health.
QPP fast facts in 5 minutes

The Quality Payment Program (QPP) began 
Jan. 1 under the Medicare Access and CHIP Reauthorization Act (MACRA) to drive clinician engagement and enhance the quality, cost effectiveness and health of the population. Read the latest installment of fast facts in 5 minutes from the Colorado QPP Coalition to help your practice succeed. The Colorado QPP Coalition, which was formed last year to help practice teams successfully transition to the new program, releases new resources monthly. Visit the web page for updates.
Capitalize on cost, utilization training

The Colorado Transforming Clinical Practice Initiative (TCPi) is offering a special educational session on cost and utilization for practice coaches working with SIM and TCPi practices. Your practice facilitators and clinical health information technology advisors will attend a full-day training session in February and follow-up trainings in the next few months. Talk with your practice coaches about how this education offered by the Network for Regional Healthcare Improvement will help you improve your patients' utilization of services.
Prime Health panel

SIM staffers will join this Prime Health panel Feb. 22 to discuss telehealth: https://www.meetup.com/Prime-Health/events/246680929/
Suggested reading

The U.S. Department of Agriculture's latest DLT grants, totaling almost $24 million, include dozens of telemedicine programs addressing everything from behavioral health to opioid abuse.

Click the above link to view Denver's first youth health assessment - a thoughtful report on the health of young people in Denver. Hundreds of Denver's youth were engaged in its creation, from participating in surveys and analyzing data to making recommendations about how to help overcome the barriers to success they identify throughout the assessment.
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The project described was supported by Funding Opportunity Number CMS-1G1-14-001 from the U.S Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS). The Colorado State Innovation Model (SIM), a four-year initiative, is funded by up to $65 million from CMS. The content provided is solely the responsibility of the authors and does not necessarily represent the official views of HHS or any of its agencies.